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Expanding Cardiac Services with Implantable Cardioverter Defibrillators

Heart Health

Sonora Regional Medical Center was recently approved to expand its Heart and Vascular service line by offering Implantable Cardioverter-Defibrillator (ICD) and Cardiac Resynchronization Therapy Defibrillator (CRT-D) procedures in its cardiac catheterization lab. The Medical Center is now offering these procedures for patients with life-threatening irregular heartbeats or heart failure.

ICDs are small, stopwatch-sized devices, implanted under the skin with one, two or three leads maneuvered through a vein into the heart. They are programmed to deliver electrical shocks or painless pacing therapy to stop ventricular fibrillation – a lethal condition in which the heart quivers chaotically and pumps little or no blood. ICDs also stop ventricular tachycardia and other less problematic arrhythmias. According to the American Heart Association, ventricular arrhythmias can lead to sudden cardiac death, a condition that kills approximately 350,000 people each year in the United States. ICDs are proven to be 98 percent effective in treating ventricular arrhythmias and it is estimated that over 70,000 lives have been saved by ICDs over the past five years.

CRT-Ds are implanted similarly to ICDs or pacemakers and provide treatment to improve the pumping efficiency of the heart. In healthy people, the four chambers of the heart contract in synchrony to move blood through the body. In many patients with heart failure, the electrical impulses that coordinate the contractions of the heart’s chambers may be impaired. As a result, the main pumping chamber no longer contracts in a symmetric fashion. This may worsen the symptoms of congestive heart failure which include shortness of breath, fatigue, and swelling of the feet and ankles. By resynchronizing the contraction of the main pumping chamber, CRT-Ds help the heart pump blood throughout the body more efficiently, giving patients with congestive heart failure improved quality of life, reduced hospitalizations and reduced mortality.

“Sonora Regional Medical Center has been providing advanced cardiac care, such as pacemaker implantation, in our cardiac catheterization lab for many years,” explains Rajiv Maraj, MD, FACC, one of five cardiologists with Sierra Cardiology. Other procedures provided in the Medical Center’s catheterization lab include diagnostic angiograms and cardiac monitor implantation.

“The addition of ICDs and CRT-Ds allows us the opportunity to save more lives by providing the right care for patients when and where they need it,” says Dr. Maraj, who played an integral role in attaining the special licensing required for the Medical Center to offer this procedure. Dr. Maraj, who has been caring for cardiovascular patients in Sonora since 2006, is certified by the International Board of Heart Rhythm Examiners in Cardiac Rhythm Device therapy. He also performs coronary artery angioplasty and stenting to treat blockages in the heart, peripheral interventions to treat blocked blood vessels in the legs and other blood vessels in the body including the use of the latest drug-coated balloon catheters, and minimally invasive laser ablation of varicose veins using conscious sedation to minimize discomfort during the procedure.

To find out if an ICD or CRT-D may help your cardiac condition, call Sierra Cardiology at (209) 536-3240. For more information about the Heart and Vascular services at Sonora Regional Medical Center, please visit